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Along with the news about the lack of equipment and oxygen cylinders to treat patients with covid-19, there have also been dramatic reports from Amazon of the alternative to which some health teams are turning to face the lack of devices mechanical ventilation: ventilation. Handbook.
In both cases, the purpose of ventilation is to artificially do the work that the patient’s lungs and body are no longer able to do to ensure respiration and oxygen circulation.
Electronic mechanical ventilation devices are more effective, but in the absence of them, teams often resort to the so-called self-inflating manual resuscitator, also known as “ambu.”
These are actuated by a hand-tight rubber pump, connected by channels until reaching the patient in a mask or in tubes inserted into the patient’s trachea.
“Manual ventilation has been frequent and has happened since the first months of the pandemic. This is due to the fact that the deficiency of (mechanical) ventilators and ICU beds in Amazonas is historical,” Dr. Pierre Souza told BBC News Brazil, specialist. in pediatrics and general surgery.
The doctor, who reports serving in emergency units in Manaus linked to the state government, says that he has already participated in several shifts in the so-called “ambu scale”, a rotation to perform manual ventilation, which requires effort and has a variable duration for each. patient.
“This chaotic situation often required spending entire nights at the patient’s bedside, doing an ambu stop, with colleagues, technicians and nurses taking turns for long periods, sometimes half an hour, an hour, an hour and a half.”
“We do this until two situations occur: either the patient is transferred to an available (mechanical) ventilator, or the patient dies. I saw it happen a few times: despite manual ventilation, the patient needed more support, parameters than the ambu it has no capacity to do. “
Jornal Nacional de TV Globo also obtained testimony from an employee of the 28 de Agosto hospital in Manaus, according to which it was also necessary to “ambush” the patients there.
“Manual ventilation occurred since the beginning of the pandemic. It is sad to see that we are experiencing a second wave and the same problems continue (from the first)”, summarizes Pierre Souza.
Crisis
Manaus is experiencing an acute crisis this month, with a lack of oxygen and a new variant of the coronavirus. The city has registered 93,000 covid-19 cases and 3,892 deaths since the start of the pandemic. The newspaper A Crítica reports that 3,800 new cases were registered in the last 24 hours, an unprecedented number in the pandemic. In the same period, 51 people died with a covid diagnosis.
The capital of Amazonas suffers a new peak in hospitalizations for coronavirus, after the holidays.
Various media outlets confirm the desperate situation in many of the city’s hospitals.
Cylinders with this gas are essential to maintain and stabilize patients with severe covid-19, as well as patients with other diseases. Without this basic contribution, many hospitalized people will end up dying.
In the midst of the dramatic lack of gaseous oxygen for the treatment of people hospitalized with covid-19 in Manaus, the Amazon Health Secretariat determined this Thursday the administrative request for “eventual oxygen stock or production” from seventeen companies, such as assemblers and producers of electrical appliances located in the Industrial Pole of Manaus (PIM).
Gree Eletric, Moto Honda, Yahama Motor, Electrolux, TPV, Whirlpool, Sodecia da Amazônia, Denso Industrial da Amazônia, Caloi, Flextronics International and Cometais. They were also affected by the request from LG Electronics, Semp TCL, Ventisol, Carrier, Daikin and Samsung.
To supply both public and private hospitals, the three local oxygen supply companies, White Martins, Carbox and Nitron, needed to deliver 76,500 cubic meters (m³) a day, says the government of Amazonas. However, the companies’ delivery capacity has only been 28,200 m³ / day.
To remedy the deficit of 48,300 m³ per day, the Government of Amazonas and the Ministry of Health are carrying out “Operation Oxygen” together.
“The logistics of the operation (to bring more oxygen to Manaus) also foresees a land route with the entrance leaving Fortaleza and going to Belém, to reach Manaus by air. In order to urgently attend to the networks, land and river transport, which would be the most common procedure, it was ruled out ”, reported the Ministry of Health.
With a seemingly endless demand for oxygen and other supplies, Manaus urgently needs help from other cities, states and, of course, the Federal Government.
In the last hours, 235 patients began to be transferred to hospitals in Goiás, Piauí, Maranhão, Brasilia, Paraíba and Rio Grande do Norte.
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